Treatments for temporal lobe epilepsy in children: a literature review

*Correspondence: [e-mail].

Abstract

Background: The Temporal Lobe Epilepsy (TLE) is one of the most common and challenging forms of focal epilepsy during both childhood and adulthood. The clinical presentation of TLE is heterogeneous and, sometimes, the pharmacotherapy plays a limited effect on its control. Facing its importance and prevalence among children, neurologists and neurosurgeons are coming up with new treatments for TLE.

Objective: Verify the current treatments for temporal lobe epilepsy in children in the last 5 years.

Methods: This study is a literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. The databases used were Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature (Lilacs) and PubMed. The descriptors were: "temporal lobe epilepsy", “children” and "treatment", using the Boolean operator AND in all databases. Inclusion criteria were systematic and literature reviews, meta-analyses and randomized clinical trials, published between 2018 and 2023 in English and Portuguese, with free full text, covering the pediatric population, and meeting the study objective. Exclusion criteria were book chapters, case reports, duplicate abstracts, and studies with only adults.

Results: 21 articles were found, and only 9 were selected after screening. The incidence and etiology of TLE in different cohorts of children have been infrequently studied. In a large group of children with TLE, there is little evidence of an initial precipitating brain injury, and, sometimes, they respond well to antiepileptic drug (AED) treatment, which spots a possible benign form of TLE. The treatment for refractory cases may involve surgical approaches such as mesial temporal resection and extratemporal cortical resection. The operation success depends highly on factors such as etiology and presence of a discernible lesion. Children with left mesial temporal resections may have postoperative declines in verbal memory, while those with extra-mesial resections do not. Children's response to antiepileptic drugs varies according to the severity of the disease. Epilepsy surgery is a useful but underutilized approach to refractory pediatric epilepsy, and can consist in potentially curative operations that can be performed to disconnect the epileptogenic zone.

Conclusion: Memory impairments are the most frequent consequences in surgery treatment involving the mesial approach

Publication History

Article published online:
12 May 2025